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Inspection Summary


Overall summary & rating

Updated 17 April 2019

We carried out this announced inspection on 14 March 2019 under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. We planned the inspection to check whether the registered provider was meeting the legal requirements in the Health and Social Care Act 2008 and associated regulations. The inspection was led by a Care Quality Commission (CQC) inspector who was supported by a specialist dental adviser.

To get to the heart of patients’ experiences of care and treatment, we always ask the following five questions:

• Is it safe?

• Is it effective?

• Is it caring?

• Is it responsive to people’s needs?

• Is it well-led?

These questions form the framework for the areas we look at during the inspection.

Our findings were:

Are services safe?

We found that this practice was providing safe care in accordance with the relevant regulations.

Are services effective?

We found that this practice was providing effective care in accordance with the relevant regulations.

Are services caring?

We found that this practice was providing caring services in accordance with the relevant regulations.

Are services responsive?

We found that this practice was providing responsive care in accordance with the relevant regulations.

Are services well-led?

We found that this practice was providing well-led care in accordance with the relevant regulations.

Background

Smile4u-Chislehurst is in Chislehurst in the London borough of Bromley. The practice provides NHS and private treatment to people of all ages.

The dental team includes a principal dentist, a dentist completing their foundation training, three associate dentists, four trainee dental nurses, a qualified dental nurse, a dental hygienist, a practice manager, and two receptionists.

The practice has three treatment rooms.

The practice is owned by an organisation, and as a condition of registration must have a person registered with the Care Quality Commission as the registered manager. Registered managers have legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated regulations about how the practice is run. The registered manager at Smile4u-Chislehurst at the time of the inspection was the practice manager.

On the day of this inspection, we obtained feedback from 73 patients.

During the inspection we spoke with the practice manager, the principal dentist, the dentist in foundation training, a trainee dental nurse and a receptionist.

We checked practice policies and procedures and other records about how the service is managed.

The practice is open from 8:30am to 5:30pm Monday to Friday, and 9am to 1pm on Saturdays.

Saturday: 9:00am - 1:00pm

Our key findings were:

  • The practice appeared clean and well maintained.
  • The provider had infection control procedures which reflected published guidance.
  • Staff knew how to deal with emergencies. Appropriate medicines and life-saving equipment were available.
  • The practice had systems to help them manage risks to patients and staff.
  • The provider had suitable safeguarding processes and staff knew their responsibilities for safeguarding vulnerable adults and children.
  • The provider had thorough staff recruitment procedures.
  • The clinical staff provided patients’ care and treatment in line with current guidelines.
  • Staff treated patients with dignity and respect and took care to protect their privacy and personal information.
  • Staff were providing preventive care and supporting patients to ensure better oral health.
  • The appointment system took account of patients’ needs.
  • Staff felt involved and supported and worked well as a team.
  • The provider asked staff and patients for feedback about the services they provided.
  • The provider dealt with complaints positively and efficiently.
  • The provider had suitable information governance arrangements.
  • The provider had effective leadership and culture of continuous improvement.
Inspection areas

Safe

No action required

Updated 17 April 2019

We found that this practice was providing safe care in accordance with the relevant regulations.

The practice had systems and processes to provide safe care and treatment. They used learning from incidents and complaints to help them improve.

Staff received training in safeguarding people and knew how to recognise the signs of abuse and how to report concerns.

Staff were qualified for their roles and the practice completed essential recruitment checks.

The premises appeared clean; patients confirmed this was the case when they visited the practice.

The equipment also appeared clean and was properly maintained

The practice followed national guidance for cleaning, sterilising and storing dental instruments.

The practice had suitable arrangements for dealing with medical and other emergencies.

All clinical staff had received appropriate vaccinations, including the vaccination to protect them against the Hepatitis B virus. The provider had checked the effectiveness of this vaccination for all members of clinical staff.

Effective

No action required

Updated 17 April 2019

We found that this practice was providing effective care in accordance with the relevant regulations.

The dental clinicians assessed the patients’ needs and provided care and treatment in line with recognised guidance. Patients described the treatment they received as being pleasant and of a high standard. They said the dental clinicians kept them informed about their care and treatment.

The dental clinicians discussed treatment with patients so they could give informed consent; they recorded this in the patients’ dental care records. They kept complete patient dental care records which were clearly written and typed, and stored securely.

The provider supported staff to complete training relevant to their roles and had systems to help them monitor this.

The practice had clear arrangements for when patients needed to be referred to other dental or health care professionals.

Caring

No action required

Updated 17 April 2019

We found that this practice was providing caring services in accordance with the relevant regulations.

We received feedback about the practice from 73 people. Patients were positive about all aspects of the service the practice provided. They described the service and care they received as being brilliant, efficient, excellent and pleasant. They described the dental clinicians as being gentle.

Patients said explanations about their dental care was given to them in a way they could understand.

Staff protected patients’ privacy and were aware of the importance of confidentiality.

Responsive

No action required

Updated 17 April 2019

We found that this practice was providing responsive care in accordance with the relevant regulations.

The practice’s appointment system took account of patients’ needs. Patients could get an appointment quickly if they were experiencing dental pain.

Staff had considered patients’ different needs. They had a removeable ramp and accessible toilet available for wheelchair users. They told us how they would support patients with enhanced needs.

The practice took patients views seriously. They valued compliments from patients and responded to concerns and complaints quickly and constructively.

Well-led

No action required

Updated 17 April 2019

We found that this practice was providing well-led care in accordance with the relevant regulations.

The practice had arrangements to ensure the smooth running of the service. These included systems for the practice team to discuss the quality and safety of the care and treatment provided.

There was a clearly defined management structure understood by all staff we spoke with.

The practice’s staff felt supported, appreciated and listened to. They appeared happy and proud to work in the practice.

The provider monitored clinical and non-clinical areas of their work to help them improve and learn. This included carrying out quality audits, and asking for and listening to the views of patients and staff.